Older adults' perceptions of adherence to community physical activity groups

© 2014 Cambridge University Press.Community physical activity (PA) groups have come in to being worldwide to inspire older adults to engage in PA. However, there is limited evidence that older adults adhere to these groups, particularly those of a lower socio-economic status, with health conditions, from black and minority ethnic (BME) groups and men. This study aimed to explore experiences of attending PA groups from the viewpoint of community-living older adults, including those sub-groups of the population highlighted above. The purpose was to gain an understanding of what would influence long-term adherence to community PA groups. Eighteen participants aged 65 and above took part in three focus groups carried out in North West England. Thematic network analysis was used for theme generation and interpretation. Low-cost, universal locations are essential to enable older adults to engage regularly in PA, however, it is the social space that is created within these physical settings that is most influential in fostering their long-term adherence. Facilitating cross-cultural relationships and supporting older adults to have more control in shaping the PA environment will ensure that these settings are more conducive to the long-term adherence of diverse groups of older adults

Future proofing the Physiotherapy Profession

Purpose To explore the role of the physiotherapist as viewed by physiotherapy academics and undergraduate physiotherapy students. The intention is to gain an insight into the future scope of the physiotherapy profession. Methods The study had an exploratory qualitative design, which was undertaken from an interpretive paradigm. A purposive sample was used to recruit participants to two focus groups. One focus group was with academic staff, the second was with 3rd year BSc (Hons) undergraduate physiotherapy students. All participants were recruited from a university in England in 2016. Both focus groups were carried out by the same researcher (SH). Each focus group interview lasted 50-70 minutes and were digitally recorded. An interview schedule was used to guide the interviews. Interview data were transcribed verbatim and analysed using thematic analysis. Results Six participants were recruited to the academic focus group; four were female. Their experience of working in academia ranged from 2 to 23 years. Seven students were recruited to the second focus group; five were female. Three themes were identified and were common to both groups: ‘philosophy of practice’, ‘changing role’, ‘tension between cultures’. Conclusion ‘Philosophy of practice’: The underpinning philosophy of practice was identified which included transferrable skills, wellbeing, and holistic care. ‘Changing role’: A changing role of the physiotherapist was identified. This included a need to incorporate health economics in healthcare provision; and an extended role with a public health focus. Participants perceived the role was being shaped by changes in the Health Service, which was shaped being shaped by the UK government’s ideology. ‘Tension between cultures’ were highlighted by both groups. This included: university and clinical practice; the market-place and practice; and current practice and the vision for the future. Implications The physiotherapy profession is ideally placed to lead the way in revolutionising the management of chronic conditions. By understanding how the profession sees itself can ensure the profession is fit for the future. From this the profession can create a vision for the future that may involve a radical change in practice, including the capacity to take on the role of public health promoters

Sensory processing and anxiety in central sensitisation pain

Background: Patients with non-specific chronic low back pain (NSCLBP) and central sensitisation (CS) have been shown to exhibit sensory processing alterations, somatosensory hypersensitivity and differences in the brain's emotional networks. The concept that the extent of CS pain might be related to the patient's own trait sensory processing and anxiety characteristics has not yet been explored. This presentation will cover the background of CS pain, sensory processing, particularly trait sensory sensitivity and its relationship to trait anxiety. There are overlapping physiological mechanisms in sensory sensitivity and the individual behavioural responses to sensory stimuli in populations with CS, anxiety and abnormal sensory processing profiles. A pilot study designed to explore this topic will also be presented. Pilot Study Objectives: To establish concept plausibility by 1) exploring the range of CS in NSCLBP patients and 2) determining potential relationships between CS pain, trait anxiety and trait sensory processing profiles Study Design: Cross sectional observation study Methods: Questionnaires were administered to N=21 NSCLBP in physiotherapy outpatient clinics in New Zealand. Excluded were those with predominantly neuropathic or nociceptive pain. Outcome measures: Central Sensitisation Inventory (CSI), Adolescent/Adult Sensory Profile, State/Trait Anxiety Inventory (Trait section) and the Marlow Crown Sociable Desirability Questionnaire. Results: 76% (N=16/21) of respondents were classed as having CS pain, scoring ≥40 on the CSI. Of those with CS pain, higher CSI scores were associated with a) abnormal trait sensory processing profiles; b) higher trait anxiety sub-types and c) minimal low trait anxiety. Higher trait anxiety scores were associated with higher Sensory Sensitivity and Low Registration sensory profile scores and lower Sensation Seeking sensory profile scores

A qualitative study to explore the experiences of First Contact Physiotherapy Practitioners in the NHS and their experiences of their First Contact role

Purpose First Contact Practitioner (FCP) roles have been developed for health professionals with advanced practice skills to take on many of the musculoskeletal responsibilities currently carried out by general practitioners. FCP roles are new and still developing. Currently there is little research that has investigated the experiences of FCPs. This knowledge could help stakeholders and other clinicians gain an understanding into what makes a successful FCP role. The aim of this research was to explore the experiences of FCP working in North West England to gain insight into the first point of contact service, and their experiences of this developing full time FCP role. Methods A qualitative design using in-depth semi-structured, face-to-face interviews was undertaken to explore the experiences of FCP providing a first point of contact service. The study took place in an economically deprived and ethnically diverse location in North West England. Findings Ten FCPs were recruited, four were appointed from Band 6 posts to FCP training posts, 9 were male. The mean years qualified was 12.8. Five themes were identified: 1. ‘It's the level of clinical complexity that you're dealing with’, 2. FCP role – rewards and challenges, 3. Own wellbeing, 4. Professional development and education, 5. Realities of working in practice governed by business. Conclusion FCP roles are an exciting development for people with MSK conditions, the physiotherapy profession, primary care providers and MSK physiotherapists. Mentorship support, workload and standards of training and practice are important when considering future expansion for the sustainability of these roles

Trait anxiety and sensory processing profile characteristics in people with non-specific chronic low back pain and central sensitisation - A pilot observational study.

Introduction People with non-specific chronic low back pain (NSCLBP) and central sensitisation (CS) exhibit sensory processing alterations, somatosensory hypersensitivity and differences in the brain's emotional networks. The concept that CS relates to pre-morbid trait sensory processing and anxiety characteristics is unknown. The aims of this pilot observational study were to test concept plausibility in a NSCLBP population with central sensitisation by investigating: 1) the range of Central Sensitisation Inventory scores, to determine the extent of symptoms of central sensitisation, 2) whether there are identifiable patient characteristics of trait anxiety and trait sensory profile differences; and 3) whether potential relationships exist between trait anxiety, trait sensory profiles and the extent of symptoms of central sensitisation. Methods People with NSCLBP and CS were recruited from physiotherapy outpatient clinics in New Zealand and the United Kingdom. Outcomes included the Central Sensitisation Inventory (CSI), Adolescent/Adult Sensory Profile and the State/Trait Anxiety Inventory (trait section) with the Marlow Crown Sociable Desirability Scale. Descriptive and non-parametric tests for correlation were used to analyse the data, p=<0.05. Results Of the 21 people recruited, 16 (76.2%) had CSI scores ≥40 in association with 1) an abnormally high prevalence of extreme scores of a) high trait Sensory Sensitive, Sensation Avoiding and Low Registration sensory profiles and b) low trait Sensation Seeking profile, 2) high trait anxiety sub-types and 3) minimal low trait anxiety. Moderate correlations were identified between trait sensory profiles and 1) CS pain (Sensory Sensitive R = 0.57, p < 0.01, CI = 0.07 to 0.88, p < 0.01, Sensation Seeking R = −0.47, p < 0.05, CI = −0.72 to −0.02) and 2) trait anxiety (Sensory sensitive: R = 0.65, p < 0.01, CI = 0.27 to 0.91) and Low Registration (R = 0.49, p < 0.05, CI = 0.03 to 0.84). The CSI scores moderately correlated with trait anxiety (R = 0.63, p < 0.01, CI = 0.22 to 0.86). Conclusion These results provide concept plausibility that the extent of CS pain in people with NSCLBP might be associated with pre-morbid trait anxiety sub-types and abnormal trait sensory processing profiles. A larger study to confirm the findings is warranted